This report describes four infants bom with an imperforate anus associated with a transscrotal fistula. This variant appears to be a low anomaly, but should be treated as an intermediate anorectal malformation.Key words Anal atresia • Transscrotal fistula ■ Child neously treated this as a low anomaly in the first patient, with a poor result, we considered the others as intermedi ate anomalies and performed a poste rior sagittal anorectoplasty (PSARP) following a previous colostomy after birth. The functional results in these patients were simulai' to those in other cases of intermediate anorectal mal formations.